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I’m long distance from folks who are in assisted living. Both have dementia, mom is really going downhill mentally and physical.

Staff took her to dentist today as she was complaining about a jagged tooth. Dentist said all her teeth but two need pulled, decay, broken etc. They will send her to oral surgeon for consult then surgery at a later date if I as POA authorize it. Then would need dentures fitted etc. Good Lord......

I talked to dental assistant and nurse at AL. Dangers are abscesses, infections etc. can’t do root canals if she would get an abscess cuz not enough of the teeth left.

At this time there are no abscesses or infections.

I didn’t see this coming. Mom’s quality of life is about .1%. I can’t imagine putting her through the horrors of all these procedures. But if I don’t, will she die of some horrible infection? Im an evil neglectful son? I’m wondering how long she has left. Should I let nature take its course or do this crazy intervention?

AL nurse, good guy who I trust, suggested going through with the consult with oral surgeon and holding him/her to absolute minimum necessary. But even that would be so traumatic for her.

Sorry this is so long, but kinda freaked out here......

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We faced this with my mom about 18 months ago. Facility dentist recommended pulling all mom's teeth and making dentures. We just said no. Two of mom's lower teeth broke off. About 3 months before she died, dentist said all of her teeth had cavities. I thanked him. There was just no way I was going to put my mom through the trauma of dental surgery.

I think, as you get closer to the end, there are just an array of bad choices. Our job is to pick the least bad ones.
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My first response is EEK, no way. That is way too much stress and trauma to put an 87 year old through who also has AD. Can the dentist just fix the one tooth she's complaining about and keep it at that? I assume it would take 3-4 painful visits over the course of one year to complete the process of pulling/replacing the teeth. I worry your mother would not adapt well to the interim conditions and the stress of that would be worse than treating a tooth "IF" indeed one does become absessed. Also, he's talking about risks that may not ever become reality. He doesn't have a crystal ball. I would choose to treat only the one tooth now - and have my mom treated for any others when and IF they become a problem.
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Sh**, I lost my post!!Windy, my mom's dentist told us he had seen many people in long term care whose teeth rotted off causing problems, some had even aspirated them. Ask to limit anything they do to the simplest and least invasive option possible, despite being referred to an oral surgeon we were able to have mom's teeth pulled with just local freezing (but she didn't have dementia so was able to cooperate). I don't think I would get dentures for your mom though, I really doubt she would be able to adapt to them.

(Mom was in her 90's at the time and although her mind was sound she was already physically in failing health, I was terrified at having her put under and so grateful to find a dentist experienced in working with frail elders)
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Update:

Talked to her old dentist yesterday. I though he’d retired but he’s still going. He agreed with me.....Said it was insane to put her through 10 extractions and she would never be able to deal with dentures. We are arranging for her to go see him. He will fix the jagged tooth and keep her going like he’s done in the past.  I should have called him from jump street but thought it would be easier on mom to go to the clinic near the AL.

Keep in mind this poor lady will be lucid one moment then look at me and say WHERE DID WINDY GO? She just scored 6 out of 30 on the SLUMS test. That’s pretty serious dementia. Gonna cut out 10 teeth on this lady? No F........ Way......
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My mom's teeth at about 95 started to just break off or fall out. They got very brittle. They looked awful where they broke off - all blackened at the root. I went over one time and she had put two of them that broke off together (and were still stuck together) on her side table, like a little shrine for the tooth fairy, LOL. I think I still have those two little teeth.

Twice, when they were in a very noticeable spot (next to the front), her wonderful dentist made her a fake tooth that he built up in 90 minutes. My mom had dementia and forgot about seeing him two days later. But she liked looking good and having a big gap in the front would have really embarrassed her.

She finally said "NO MORE DENTISTS". I also worried about infections and pain. But mom didn't suffer. She died at 97.5 and went out pretty well. If it was me, I'd do the least amount possible to ease her suffering and pain and just keep an eye on it. I don't think that most medical professionals understand the ramifications of what they're recommending for the super-elderly. Having ten teeth pulled with dementia is a big undertaking. I'd try not to do it, or do it over a very long period of time, with very small treatments each time to see how they go. {{{Hugs}}} None of this is easy!
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If she gets an abscess there is not enough left of any teeth to do a root canal. So that could be a one time extraction process I suppose.

Mom still has her front teeth, upper and lower. Dentist says these gotta go too. I cannot even imagine her shock at waking up with no teeth. She may have advancing dementia but she still has some vanity. I think she’d rather be dead. She has a DNR that is very clear....I DONT WANT NO NOTHING NO WAY NO HOW!
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(((((((windy))))) It doesn't stop does it?

Leaving the rotten teeth in her head will likely lead to infection/abscess sooner or later. They are pretty traumatic too. I like what the AL nurse said. Go with the minimum necessary. I think she is in for trauma one way of another, eventually, Maybe better to get it out of the way so she doesn't have further problems in that area as she declines. Tough decisions.
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A good dentist could just file down that jagged edge and be done with it. My personal dentist recommended a dentist who was good with seniors. That's where I took mom and he was outstanding. Maybe ask her old dentist for a recommendation or ask his advice when he calls you back.
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Windy, I would get a second opinion, though, I know that is easier said than done. The reason I suggest that is that I got VERY different recommendations from dentists for my LO. One wanted her to undergo deep cleaning under anesthesa, referred her to the dental school that was hours away. That was not feasible, to me, so I got a second opinion from a dentist that I knew and he treats patients with dementia. He was able to come up with a plan of regular cleaning in office, a few extractions and good oral hygiene regimen at the MC. (Prescribed brushing and oral rinse twice a day. If prescribed, they have to do it for her.) She did fine with the office cleaning a few extractions and is doing fine.

Dentists opinions vary greatly based on what I have observed. Maybe, her old dentist will understand the situation.

I wanted to avoid dentures at all cost. It's just not feasible for people with severe dementia, but, I have been told that they can eat pretty well, even if they have few teeth. As long as it's soft food.
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Thanks all for sharing your experiences. I’m good here.....NO TEETH PULLING

The AL is arranging to take mom to her old dentist. I talked to him yesterday. He’s going to grind off the rough edges. Done......
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